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Abstract: GIC (GLASS IONOMER CEMENTS) is the versatile material used in dentistry
since 1871, but it’s use resurged recently as an ideal cementing material. In view of it’s wide
use in dental practice, the discussion of GIC is important to the dental practitioners.
Key words: GIC (Glass Ionomer Cements), Dental Cement Material.
INTRODUCTION
“Necessity is the mother of invention”. It was the late 1960’s. History had already witnessed a
host of restorative materials including amalgam, composite, cast alloys etc. but all had fallen
short of that certain perfection that the dental researches and clinician yearned for…..that of a
material that would be esthetic, adhesive, biocompatible, anticariogenic and relatively
economical. It was during this time that cement came into the picture and created quite a
sensation by not only possessing a majority of the desirable properties but also providing
much scope for modification and improvement. This was the Glass Ionomer Cement.
Glass ionomer is a combination of ‘Glass’powder and ‘ionomer’-ic acid GIC can be defined
as a water- based material that hardens following an acid-base reaction between the basic
fluoro aluminosilicate glass powder and an acidic solution of polyacrylic acid.
Composition
Powder = Is basically an acid soluble calcium aluminosilicate glass containing fluoride. It is
formed by fusing silica + alumina + calcium fluorite, metal oxides and metal phosphates at
11000-15000 C and then pouring the melt onto a metal plate / into water. The glass formed is
crushed, milled and ground to a form powder of 20 – 50 size depending on what it’s going
to be used for. They get decomposed by acids due to the presence Al +3 ions which can easily
enter the silica network. It is this property that enables cement formation.
Functions of components:
Alumina (Al2 O3)
- Increase opacity
Silica (SiO2)
- Increase Translucency
Fluoride: Its has 5 functions
- Decrease fusion tO
- Anticariogenecity
- Increase translucency
- Increase working time
- Increase strength
Calcium fluoride (Ca F2)
- Increase opacity
- Acts as flux
Aluminium phosphates
- Decrease melting to
- Increase translucency
Cryolite (Na3 Al F6)
- Increase translucency
- Acts as flux
International Journal of Plant, Animal and Environmental Sciences Page: 26
Available online at www.ijpaes.com
Mahesh et al IJPAES
BIOCOMPATIBILITY:
Adverse affect of GIC on living tissues are minimal. Any inflammatory response of pulp
towards GIC due to its high initial pH of 0.9 to 1.6 resolves within 20-30 days. No ill effects
are caused by PAA because:
- PAA is a weak acid, which becomes weaker when partly neutralized
- Its diffusion into the tubular dentin is unlikely due to its high molecular weight and
heavy chain entanglement
- It gets readily precipitated by the calcium ions in the tubules.
- Dissociated H+ ions remain near the chain due to electrostatic attraction
The occasional post insertions sensitivity encountered on luting full crowns is due to
- The high initial pH {2.33 (PAA) liquid and 1.76 (water settable)}which persists for
about 5 mins.
- Lower P: L ratio
- Pre-existing pulpitis
- Minimal D thickness to prevent this, certain precautions should be taken.
- Don’t remove smear layer
- Protect deep areas of cavities with Ca (OH)2
ANTICARIOGENECITY:
GIC has the unique property of being cariostatic due to the sustained release of
fluoride, which confers resistance to caries not only on the restored tooth but also on the
adjacent tooth. The influence of fluoride is found in a zone of resistance to demineralization,
which is at least 3mm thick around a GIC restoration.
Fluoride contributes to carious inhibition in the oral environment by means of both
- Physicochemical mechanism
- Biologic mechanism
AESTHETICS:
A degree of translucency exists for GIC due to the glass fillers. Its translucency
depends on its formation. It is important to note that because of slow hydration reactions,
Glass ionomer takes at least 24hrs to fully mature and develop translucency. Translucency
increases as the cement ages. Resistance to stain is largely dependent on obtaining a good
surface finish. The colour seems to be unaffected by oral fluids as compared to composites
which tend to stain.
DIMENSIONAL STABILITY:
A correctly manipulated and protected GIC shows a volumetric setting contraction of
~ 3%. At higher humidities, the cement tends to absorb water and expand so much so that a
net expansion occurs while at lower humidities, a low shrinkage occur.
DISSOLUTION AND DISINTEGRATION:
The loss of soluble matrix forming species from the cement can lead to disintegration of
the cement. This can be caused by:
- Early water contamination
- Chemical attack such as plaque acids / APF gel application
- Mechanical wear
It is mandatory to protect the GIC in its first ½ hour of life. A solubility of only 0.4% (wt) is
seen as compared to other cements
DURABILITY AND LONGEVITY:
According to one study, the GIC restoration evaluated in erosion-abrasion lesions,
83% showed retention even after 10yrs. Failure rate ranges from 0-70%, which is more of a
measure of the clinicians skill than of the inherent quality of the material
STRENGTH:
One of the major limitations of GIC is their susceptibility to brittle fracture. As
compared to composite and amalgam, GIC’s are weak and lack rigidity. The weakness
appears to be in the matrix, which is prone to crack propagation. A certain degree of porosity
also develops as it is a 2 part material, which needs to be mixed prior to placement
International Journal of Plant, Animal and Environmental Sciences Page: 28
Available online at www.ijpaes.com
Mahesh et al IJPAES
RADIOPACITY:
GIC are fairly R/O due to inclusion of radio opacifies like BaSO4. Most GIC’s are slightly
more radiopaque than dentin and can be differentiated in radiograph.
Clinical Uses: According to Philip’s classification
Luting cements (TYPE 1):
The ideal properties of a luting cement according to Mc Lean and Wilson are :
Low viscosity and film thickness
Long working time and rapid set at mouth temperature
Good resistance to aqueous acid attack
High compression and tensile strength
Resistance to plastic
Adhesion to tooth structure
Cariostatic properties
Biological compatibility with the pulp
Translucency
Radiopacity
Restorative Cement (Type II) :
Indications:
o The erosion/abrasion lesion
o Class V lesion
o Restoration of primary teeth
o Class III lesion
o Laminate restoration
o Microcavity preparation = box,slot,tunnel
o Atraumatic Restorative Treatment (ART)
o Patients prone to rampant caries
o Small medium sized class I lesion
o Repair of open margins around crowns and inlays.
The Powder:Liquid (P:L) = 3:1 As mentioned before, correct surface treatment, manipulation
and protection are essential for a long lasting restoration.
Liner and base (TYPE III):
A lining cement is basically used to protect the pulp from temperature change, by
sealing dentinal tubules. It needs to be only 0.5mm thick. They have low physical properties
and are used to fill voids in cavity preparation. The P:L = 1.5 : 1
A base is used as a dentin substitute. According to Mount, the entire cavity should be
filled with GIC and then cut back to make room for amalgam /composite.
Other Uses:
Orthodontic luting cements:
Luting cements are needed to effect a stable attachment of bands and brackets during
tooth movement. A common clinical problem is
o demineralization and caries under brackets and bands
o detachment causing schedule disruption and Rx delay.
Both these problems can be solved by using GIC as F release reduces demineralization under
brackets and bands. Conventional GIC has shown proven benefit over Zn PO4 for band
cementation with regard to retention and decreased demineralization.
Core build up:
The construction of a core is often necessary prior to crown preparation in order to give the
final crown appropriate resistance and retention. Traditional GIC lack the necessary tensile
and flexural strengths for anything other than small core build ups or blocking out under cuts
in preparations.
GIC in endodontics:
They are used for:
o Sealing root canals orthogradely and retrogradely
o Restoring pulps chamber
o Perforation repair
o Sometimes for repairing vertical fracture.
REFERENCES